Authorization Specialist
1 week ago
**About SpecialtyRx**
SpecialtyRx is a leading provider of pharmaceutical services to long-term care facilities and assisted living communities. We take pride in delivering personalized care and quality pharmacy services.
**Job Summary**
We are seeking a highly skilled Authorization Representative to join our Billing Department. Under general supervision of the Billing Manager, and in accordance with local, state, federal and company laws and regulations, the successful candidate will provide a variety of Billing functions.
**Key Responsibilities**
- Perform duties assigned by the Billing Supervisor, ensuring timely and accurate completion of tasks.
- Evaluate medication orders and prescriptions from long-term care facilities, identifying high-cost medications requiring authorization for dispensation.
- Liaise with facility staff to gather patient information and clinical documentation, facilitating the authorization process.
- Initiate and manage the authorization process for high-cost drugs, ensuring timely approval and communication with healthcare providers and payers.
- Maintain accurate records of authorization requests, approvals, and denials, providing valuable insights for process improvement.
- Provide guidance to facility staff on medication authorization procedures and requirements, ensuring compliance with regulatory guidelines and payer policies.
- Stay updated on regulatory guidelines and payer policies related to high-cost drug authorizations, ensuring the company remains compliant and competitive.
- Communicate effectively with internal teams and external clients regarding authorization status and issues, building strong relationships and trust.
- Participate in training sessions and quality improvement initiatives to enhance authorization processes, driving continuous improvement and excellence.
- Assist in resolving any discrepancies or issues related to medication authorizations, providing timely and effective solutions.
**Requirements**
- Licensed Pharmacy Technician required.
- Experienced in Long Term Care Pharmacy preferred.
- Courteous and polite phone skills.
- Computer literate.
- Previous experience in Retail pharmacy a must.
- Must be detail-oriented.
- Must be able to multitask.
**Work Schedule**
Remote hours: 5:00pm – 1:30am, Tuesdays – Saturdays.
**Equal Employment Opportunity**
SpecialtyRx, Inc. is fully committed to employing a diverse workforce. We recruit and retain talented individuals without regard to gender, race, age, marital status, disability, veteran status, sexual orientation and gender identity or any other status protected by federal, state or local law.
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